Module 7

Expanded Programme of Immunization (EPI)

(including Vitamin A, Tetanus Toxoid
and Growth Monitoring)

CONTENTS

7.1 What are the tools used for data collection? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

7.2 Who is responsible for collecting the data? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
7.3 What data should be collected and how? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
7.4 How and when should the data be reported? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
7.5 How should the data be interpreted and used? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

ILLUSTRATED GUIDES

> Illustrated Guide to EPI Tally Sheets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12

> Illustrated Guide to EPI Report . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14

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 Health Information Part Two:
System (HIS) Technical Sections

Expanded Programme of Immunization (EPI)

(including Vitamin A, Tetanus Toxoid and Growth Monitoring)

7.1 WHAT ARE THE TOOLS USED FOR DATA COLLECTION?

The data collection tools used in the EPI programme are shown below. They are classified as
follows:

Primary Tools
Primary data sources are essential to routine monitoring within the HIS and are prerequisite to the
calculation of indicators. They form the basis of the guidance and training within this manual, and
are described in detail in the Illustrated Guides at the end of the module.

Secondary Tools
Secondary data sources have important functions within the HIS but are not directly used to
calculate indicators. They have a role in informing clinical decision-making and promoting service
quality and performance. They are described in information boxes in the supporting text.

> Data collection and monitoring tools

EPI, Vitamin A, Tetanus Toxoid and Growth Monitoring

Primary Tools
1. EPI Tally Sheet
2. Vitamin A Tally Sheet
3. Tetanus Toxoid Tally Sheet
4. Growth Monitoring Tally Sheet
4. EPI Report


Secondary Tools
1. Road to Health Card
2. Under Five Register
3. NCHS/WHO Reference Values

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7.2 WHO IS RESPONSIBLE FOR COLLECTING THE DATA?

The basis of data collection in EPI is a tally sheet, which should be maintained each day in all
health facilities. One EPI staff member should be designated responsibility to record the data each
day and should decide how many tally sheets are required during the course of a week. More
than one tally sheet may be filled, particularly if a large number of children are vaccinated daily.
However, no single tally sheet should last for more than one reporting week.

The clinic supervisor is responsible for compiling the EPI report at the end of the week. This should
begin with the gathering of tally sheets used in each clinic at the end of each week, ensuring that
forms are submitted on time and corresponding to the week in question.

The EPI Report should be completed by transferring summed totals from the tally sheets into the
reporting form, and submitting to the Health Manager in each camp (see 3.4 How and When should
the data be reported?).

7.3 WHAT DATA SHOULD BE COLLECTED AND HOW?

The EPI Tally Sheet records the number of doses of vaccine administered each day according to the
age of the child and the type of antigen. The list of vaccines will be determined by the national
immunization schedule within each country and monitoring requirements should be adapted
accordingly (see Country Considerations Box).

Doses of vaccine should be tallied immediately after they have been administered to each child.
A tally should not be made before the vaccine is administered, as the child may not receive the
vaccine. Nor should tallying be left to the end of a session and based on the number of doses left
in the used vials as this can lead to “wasted” doses being recorded.

7.3.1 Immunization Status

In most national schedules, measles vaccination completes the EPI timetable at 9 months of age.
The immunization history should be reviewed at this point to verify the complete and timely
provision of all EPI vaccines in the schedule. This information should be available from the Road To
Health Card and from the Under Five Register (see Secondary Tools Box).

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If a child has received all required vaccine doses in the immunization schedule, only then can
s/he can be declared fully immunized and tallied accordingly. Clinic staff should not record a child
as fully immunized until the complete vaccination history has been verified in the Road to Health
card and the Under Five register.

The monitoring requirements of Tetanus Toxoid, Vitamin A and Growth Monitoring programmes
share many similarities with EPI. Services are often integrated and delivered at the same location
and all rely on tally sheet as the primary tool of data collection and reporting. Each is described
under the common set of guidelines below.

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> Country Considerations

What is the national immunization schedule?

The routine immunisation schedule in most countries comprises six vaccine preventable diseases:
namely measles, diphtheria, pertussis, tetanus, polio and tuberculosis (see Table 1). Before the age
of one year the schedule should be completed by all children.

Women of childbearing age should also be given tetanus toxoid vaccine to prevent neonatal
tetanus (see Table 2). The mothers and their future babies obtain full protection after completing
the TT schedule. Routine vitamin A distribution is often integrated within national EPI programmes,
and targets children aged 6 - 59 months and post-natal mothers (see Table 3).

The national schedule for each programme should be reviewed and monitoring requirements
within the HIS adapted accordingly.

Table 1. Recommended schedule for routine immunisation (WHO)*

New visit Diseases Age
BCG Tuberculosis At birth
DPT Diphtheria, Pertussis, Tetanus 6, 10, 14 weeks
OPV Polio At birth, 6, 10, 14 weeks
Measles Measles 9 months
* Depending on national priorities, Ministries of Health may have introduced (or have long-term plans to introduce)
“new” and under-used vaccines, such as hepatitis B (HepB), hemophilus influenzae type b (Hib) and Yellow Fever.

Table 2. Recommended schedule for Tetanus Toxoid administration (WHO)

Dose Time for administration Duration of protection
TT1 At first contact No protection
TT2 4 weeks after TT1 Three years
TT3 At least 6 months after TT2 Five years
TT4 At least 1 year after TT3 Ten years
TT5 At least 1 year after TT4 For thirty years**
** throughout a woman’s reproductive life

Table 3. Recommended schedule for Vitamin A distribution

Age group Dosage Frequency
< 6 months 50 000 IU 6, 10, 14 weeks
6 - 12 months 100 000 IU Every 4-6 months
≥ 12 months 200 000 Every 4-6 months
Mothers 400 000 ≤ 6 - 8 weeks postpartum

Note: If MoHs require data on other vaccines (e.g. Yellow fever, pneumococcal), or if they require reports on booster
doses given after the age of one, this can be collected using the Additional EPI Reporting form. More information on
how to activate this form is given in Part 3 of the manual.

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> Secondary Tools

Under Five Register

Birth registration is a fundamental human right and an essential means of protecting a child’s
right to identity. Registering a birth serves to legally acknowledge a person’s existence, enables a
child to possess a birth certificate, establishes family ties, and tracks major milestones from birth
through to marriage and death. Birth registration also helps governments, UN agencies, and
health partners to track demographic statistics and trends in each camp.

It is imperative that the HIS supports a mechanism to register every child at or shortly after birth.
This is most often done in an Under Five Register, supplied by the national MoH and/or the
UNICEF country office.

The Under Five register should be used as a centralised record of this information, and a summary
also recorded in a ‘Road to Health’ card that is kept by the child’s mother at all times and updated
during each visit to the clinic (see below).

‘Road to Health’ card

The ‘Road to Health’ card provides a useful medical summary of a child’s health in the first five
years of life. These are most important in a child’s development, and should be closely monitored
to ensure timely detection of problems and early diagnosis and treatment. The card is given
to mothers when their infant is born and is updated regularly at the MCH clinic until the child
reaches his or her fifth birthday.

Each card contains a record of immunisations and growth rate. To facilitate the rapid assessment
of growth at each visit, the World Health Organization (WHO) has taken the National Centre for
Health Statistics (NCHS) curve and modified it for use in Road To Health cards. Weight-for-age
(WFA) screening measurements taken at growth monitoring are plotted within the NCHS/WHO
growth curve and displayed within a percentile range.

The WFA growth curves are often colour-coded, to draw attention to children that fall within a
percentile range that is below accepted thresholds. The exact parameters will depend on the
national policy in each country. Children identified as low WFH should be referred immediately
to the Supplementary Feeding Programme for weight-for-height (WFH) measurement (for more
details see Module 8: Nutrition).

The card also identifies the child to other relevant primary healthcare programmes (e.g. PMTCT,
supplementary feeding) and is an important tool in promoting integrated delivery of care between
these sections. It should be kept by the mother at all times, and updated alongside the Under-Five
register at each visit.

Tetanus Toxoid Card

This card is a record of each individual’s tetanus toxoid history, and is most often supplied by the
MoH and/or UNICEF country offices.

It should be requested and updated each time a dose of vaccine is administered. This information
may also be registered centrally in a Tetanus Toxoid Register, to provide a secure reference source
in the event that individual cards are lost or stolen.

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7.3.2 Vitamin A distribution

Vitamin A tally sheets should be available in all health units for monitoring of routine capsule
distribution to children under five. Capsules should be tallied as they are administered according
to the schedule and target ages specified within the national policy (see Country Specifications Box).

The monitoring of post-natal vitamin A distribution will need to be adjusted the suit the
configuration of services in each health agency. Responsibility should fall to either EPI staff or
nursing staff on the maternity ward. Tally sheets should be made available to each location as
indicated. In camps where capsules are distributed by maternity unit staff, the nurse/midwife in-
charge should supervise complete recording of information each day and ensure that the figures
are compiled into the EPI report at the end of each week.

7.3.3 Tetanus Toxoid distribution

The daily administration of each Tetanus Toxoid (TT) dose should be recorded in a separate tally
sheet in each health unit. Monitoring requirements should be aligned with the schedule and target
groups specified within the national policy (see Country Specifications Box). Groups most commonly
targeted for TT immunization in national programmes are pregnant mothers and women of child-
bearing age. Other groups at high-risk of exposure should also be provided coverage as and when
required.

In addition to logging data in a tally sheet, the administration of each Tetanus Toxoid dose should
be documented on a vaccination card that is kept by the individual (see Secondary Tools: Tetanus Toxoid
Card). This is important to preserve the continuity of care and to ensure the vaccination schedule
is followed correctly. Pregnant women who receive TT vaccine as part of routine antenatal care
should also have this information documented in the Antenatal Care Register (see Module 9.1:
Antenatal Care).

7.3.4 Growth Monitoring

All children under five should attend for growth monitoring in the MCH clinic at least once per
month as part of every comprehensive primary health care programme. The observed weight
measured at each visit should be converted to a weight-for-age (WFA) percentile and registered
in a daily tally sheet according to the age of the child.

WFA percentile is calculated by plotting the observed weight in the growth curve on each child’s
‘Road To Health’ card (see Secondary Tools Box). Staff should understand how to correctly utilise
and interpret the information contained in these cards, and should place equal importance on
educating mothers to recognise danger signs. The design of these cards and the WFA percentile
cut-offs, will depend on the policies of the host MoH. Nutrition policy and monitoring requirements

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should be adjusted accordingly to reflect these national differences.

Data collection in all growth monitoring programmes should include the criterion of bilateral,
pitting oedema. Staff should receive training on how to recognise and diagnose this cardinal sign
of severe malnutrition and the nutrition policy in each country should provide specific referral and
management guidance for such cases.

An Illustrated Guide to the Tally Sheets used in EPI and an explanation of the information that
should be recorded is given at the end of the module.

7.4 HOW AND WHEN SHOULD THE DATA BE REPORTED?

At the end of each week all Tally Sheets should be gathered and used to compile the respective
tables within the EPI Report.

The dates of the reporting weeks are shown in the Reporting Calendar. It is important that all staff
are aware of these dates, and that copies the calendar are distributed to all health units.

The EPI supervisor is responsible for coordinating the complete and timely submission of the EPI,
Vitamin A, Tetanus Toxoid and Growth Monitoring tally sheets in each clinic.

7.4.1 Converting tallies to numbers

Prior to submission of the tally sheets at the end of the week, the EPI staff member designated to
record the information should convert the tallies into numerical figures. These numbers should be
entered clearly into the black Number Boxes in the bottom right-hand corner of each Tally Box (see
Illustrated Guide to EPI Tally Sheet). The EPI supervisor should verify that a random sample of 10 – 20
tallies in the daily forms have accurately been converted into numbers.

7.4.2 Weekly EPI Report

Using a calculator, the figures in the number boxes in each tally sheet should be added, and the
weekly total transferred into the corresponding table in the EPI Report (see Illustrated Guide to EPI
Report). Data should be disaggregated according to the age of the child (< 1, ≥1 - 5), status (refugee
or national) and the type of antigen administered (including dose number where appropriate).

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> Country Considerations

Which vaccine dose-vial sizes are used in each national programme?

Each week, the EPI programme in each camp should report the number of doses of each
vaccine that were supplied to each camp. To accurately report this information, staff should
know the number of doses that are contained within each vial of vaccine.

The most common dose-vial sizes are shown in Table 1. Exact combinations will vary depending
on specific programme requirements and the stock availability of the MoH and/or UNICEF office
in each country.

Table 1. Common dose-vial sizes

Vaccine Doses per vial*
BCG 20
Polio 20
DPT 10
Measles 10

* Also available in 1, 2, 5 , 6 dose vials depending on programme requirements

If there is more than one unit reporting in each camp, the information from each should be
combined to create one weekly report for the entire camp. Photocopies of the weekly report form
may be required to assist units compile their individual reports prior to aggregation into the camp
report.

7.4.3 Vaccine Supply and Wastage

Each week, the EPI programme should report the number of doses of each vaccine that were supplied
to each camp. This vaccine supply data is important for the calculation of vaccine wastage at the end
of each month. The MCH supervisor should enter the number of doses of vaccine supplied to each
camp into the corresponding table in the EPI Report. This data is not collected in tally sheets and
therefore requires separate records to be kept in each cold chain facility.

To ensure accurate reporting, it is vital that all staff appreciate the important distinction between
‘vials’ and ‘doses’ of vaccine (see Country Considerations Box). The figure entered in the weekly
report must also take into account any unused doses of vaccine which were able to be returned
to the fridge.*

* Note: as BCG and Measles are live attenuated vaccines, opened vials of these vaccines cannot be preserved. Vaccine wastage is therefore

expected to be higher for these antigens

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An Illustrated Guide to the EPI Report, and an explanation of how the information should be
reported from daily sources, is given at the end of the module.

7.4.4 Monthly EPI Report

At the end of each week the paper-based report forms can be directly entered into the computer.
The database will then automatically combine these into a monthly report composed of 4 or 5
weekly reports, depending on the reporting calendar. More information on data management
and is given in Part 3 of the manual.

7.5 HOW SHOULD THE DATA BE INTERPRETED AND USED?

The indicators for EPI, Vitamin A, Tetanus Toxoid and Growth Monitoring are shown opposite.
Each is classified according to the five core objectives of the HIS and is used to monitor progress
towards its achievement. A summary of each indicator, including formulae, units of expression,
and the corresponding standard (where available) is given in the Standard and Indicator Guide
that accompanies this manual.

It is essential that staff are familiar with how these indicators are calculated, and understand how
they should be used to evaluate programme performance and to inform public health decision-
making. A group exercise on how to calculate and interpret the indicators, using sample data, is
given in the CD-ROM that accompanies this manual.

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> Indicator Summary

EPI, Vitamin A, Tetanus Toxoid and Growth Monitoring

Objective Indicator Source

3. Evaluate the effective- Vaccination coverage* UNICEF
ness of interventions and
service coverage Post-natal Vitamin A HIS
coverage
Coverage of growth HIS
monitoring
4. Ensure that resources Vaccination wastage rate* UNICEF
are correctly targeted to
the areas and groups of
greatest need
5. Evaluate the quality of Programme drop-out rate UNICEF
health interventions

* Disaggregated by antigen, as specified in national schedule

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> Illustrated Guide to EPI Tally Sheets

Health Information System

A Organisation:

Daily Tally Sheet Location:

7.1a Children Vaccinated Reporting period:

Number of doses Refugee National

B administered <1 ≥ 1 to < 5 <1 ≥ 1 to < 5

00000 00000 00000 00000 00000 00000 00000 00000 00000 00000
BCG
00000 00000 00000 00000 00000 00000 00000 00000 00000 00000
00000 00000 00000 00000 00000 00000

00000 00000 00000 00000 00000 00000 00000 00000 00000 00000
Polio 0 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000
00000 00000 00000 00000 00000 00000

00000 00000 00000 00000 00000 00000 00000 00000 00000 00000
Polio I 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000
00000 00000 00000 00000 00000 00000

00000 00000 00000 00000 00000 00000 00000 00000 00000 00000
Polio II 00000
00000
00000
00000
00000
00000
00000 00000
00000
C00000
00000 00000 00000
00000
00000 00000

00000 00000 00000 00000 00000 00000 00000 00000 00000 00000
Polio III 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000
00000 00000 00000 00000 00000 00000

00000 00000 00000 00000 00000 00000 00000 00000 00000 00000
DPT I 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000
00000 00000 00000 00000 00000 00000

00000 00000 00000 00000 00000 00000 00000 00000 00000 00000
DPT II 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000
00000 00000 00000 00000 00000 00000

00000 00000 00000 00000 00000 00000 00000 00000 00000 00000
DPT III 00000 00000 Health
00000 00000 00000Organisation:
00000 00000 00000 00000 00000
Information System
Daily Tally Sheet
00000 00000 00000 00000 00000
Location:
00000
7.5 Growth Monitoring Reporting period:
Health Information System Organisation:

Daily Tally Sheet Location:

Refugee
National
00000 00000 00000 00000 <1
00000 00000
≥7.4
1 to < 5Tetanus
00000
Toxoid 00000 Reporting
00000 00000 System
Health Information
period: Organisation:

Measles 00000 00000 00000

Green 00000
00000 00000
00000
00000
00000
00000
00000
00000
00000
00000
00000
00000 00000 00000
00000 00000
0000000000
00000 00000 00000
00000 00000 00000
00000
00000Refugee 000007.3
Daily Tally Sheet
00000
Location:

National
Vitamin A Reporting period:
(normal) Number of doses
00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000
Non- Non-
00000 00000 00000 00000 00000
administered
00000 00000
00000
00000
00000
00000
00000
00000
00000
00000 00000 00000
00000 00000 00000 00000
00000 00000 Pregnant
00000
00000
00000
00000
Pregnant
00000
Other Pregnant
Pregnant
Other

00000 00000 00000 00000 00000 00000 00000 00000 00000

00000 00000
00000 00000
00000 00000 00000 00000 00000Doses
00000distributed
00000 00000 00000 Refugee National
TT 1 00000 00000
00000 00000
00000 00000 00000 00000 00000 00000 00000 00000 00000
00000 00000 00000 00000 00000 00000 00000 00000 00000
00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000
00000 00000 00000 00000 00000 00000 00000 00000 00000
00000 00000
00000 00000
00000 00000 00000 00000 00000 00000 00000 00000 00000
00000 00000 00000 00000 00000 00000 00000 0000000000 00000 00000 00000 00000 00000
Post-natal
Fully
00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000
00000
00000 00000 00000 00000 00000 00000 00000 00000 00000
00000 00000 00000 00000 00000 00000 00000 00000
00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000
00000 00000 00000 00000 00000 00000 00000 00000 00000
00000 00000
00000 00000
00000 00000 00000 00000 00000 00000 00000 00000 00000
00000 00000 00000 00000 00000 00000 00000 00000 0000000000 00000
00000 00000 00000 00000 00000 00000
00000
00000 00000 00000 00000 00000

Vaccinated
00000
00000 00000 00000 00000 00000 00000 00000
00000 00000 00000 00000
00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000
00000
00000 00000 00000 00000 00000 00000 00000 00000 00000 00000
00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000
00000 00000
00000 00000
00000 00000 00000 00000 00000 00000 00000 00000 00000
00000 00000 00000 00000
00000 00000
00000
00000 00000 00000
00000
00000 00000 00000 00000 00000
TT 2 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000
00000 00000 00000 00000 00000 00000 00000 00000 00000
00000 00000
00000 00000
00000 00000 00000 00000 00000 00000 00000 00000 00000
00000 00000 00000 00000 00000 00000 00000 00000 00000
00000 00000 00000 00000 00000 00000 00000 00000 00000
00000 00000
00000 00000
00000 00000 00000 00000 00000 00000 00000 00000
00000 00000
00000 00000 00000 00000 00000 00000 00000 00000
00000 00000 00000 00000 00000 00000 00000 00000 00000
00000 00000 00000 00000 00000 00000 00000 00000 00000 00000
00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000
00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000
Dose 1 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000
00000 00000 00000 00000 00000
00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000
00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000
Yellow 00000 00000 00000 00000 00000 00000 00000 00000 00000
00000 00000
00000 00000
00000 00000 00000 VAC00000TALLY_EN_090109
00000 00000 00000 00000 00000
00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000

(borderline) 00000 00000 00000 00000

TT 3 00000 00000 00000
00000 00000 00000 00000 00000 00000 00000
00000
00000
00000
00000
00000 00000 00000 00000 00000 00000 00000 00000 00000
00000 00000 00000 00000 00000
00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000
00000 00000 00000 00000 00000 00000 00000 00000 00000
00000 00000 00000
00000 00000 00000 00000 00000 00000 00000 00000 00000
00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000
00000 00000 00000 00000 00000 00000 00000 00000 00000
00000 00000 00000
00000 00000 00000 00000 00000 00000 00000 00000 00000
00000 00000 00000 00000 00000 00000 00000 00000 00000
00000 00000 00000 00000 00000 00000 00000 00000 00000
00000 00000 00000
00000 00000 00000 00000 00000 00000 00000 00000
00000 00000
00000 00000 00000 00000 00000 00000 00000 00000
00000 00000 00000 00000 00000 00000 00000 00000 00000
00000 00000 00000
00000 00000 00000 00000
00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000
00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 Dose
00000 2 00000 00000 00000
00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000
TT 4 00000
00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000
00000 00000 00000 00000 00000 00000 00000 00000 00000 00000
00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000
00000 00000 00000 00000 00000 00000 00000 00000 00000
00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000
Red 00000 00000 00000 00000 00000 00000 00000 00000 00000
00000 00000
00000 00000
00000 00000 00000 00000 00000 00000 00000
00000
00000
00000
00000
00000 00000 00000 00000 00000 00000 00000 00000 00000
(danger) 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000
00000 00000 00000 00000 00000 00000 00000 00000 00000
00000 00000
00000 00000
00000 00000 00000 00000 00000 00000 00000 00000 00000
00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000
00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000
00000 00000 00000 00000 00000 00000 00000 00000
00000 00000 00000 00000 00000 00000 00000 00000 00000
00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000
00000 00000 00000
TT 5 00000 00000
00000 00000 00000 00000 00000 00000 00000 00000
00000 00000 00000 00000 00000 00000
00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000
Oedema
00000 00000 00000 00000 00000 00000 00000 00000 00000
00000 00000 00000 00000 00000 00000 Dose
000003 00000 00000 00000
00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000
00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000
00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000
00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000
00000 00000 00000 00000
GROWTH TALLY_EN_090109
00000 00000 00000 00000 00000 00000 00000
00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000
00000 00000 00000 00000 00000
00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000
00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000
TET00000 00000
TALLY_EN_090109 00000 00000 00000 00000 00000 00000 00000
00000 00000 00000 00000 00000 00000 00000 00000 00000

VIT A TALLY_EN_090109

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A HEADER:

Organisation:
Print name of health partner

Location:
NOTES
Print name of Camp and Reporting Unit
It is the responsibility of a designated EPI officer to maintain
correctly use each tally sheet. A new sheet should be used if any
Reporting period: one of the tally sections is filled.
Enter number of week and month (e.g. Week 1
No single tally sheet should be used for more than one reporting
March) week.

B SERVICE PROVISION:
EPI Vitamin A
Strike a tally corresponding to: Strike a tally corresponding to:
> Vaccine (antigen-specific) > Capsule (dose-specific)
> Status (Refugee / National) > Status (Refugee / National)
> Age (< 1 / ≥ 1 to < 5; for refugees only)
Growth Monitoring
Tetanus Toxoid Strike a tally corresponding to:
Strike a tally corresponding to: > WFA or MUAC zone (Green / Yellow / Red)
> Vaccine (dose-specific) > Status (Refugee / National)
> Status (Refugee / National) > Age (< 1 / ≥ 1 to < 5; for refugee only)
> Target Group (Pregnant / Non-pregnant /
Other; for refugees only)

C NUMBER BOXES:
Before submitting the tally sheet at the end of the
week, count the number of tallies in each box and
convert to a number.
> Write number clearly in the black square in the
bottom right hand corner of each tally box
NOTES
It is the responsibility of the designated EPI officer responsible
for the form to convert tallies to numbers PRIOR to submission
at the end of the week.
The clinic supervisor should check a random sample of 10 - 20
tally conversions for accuracy at the end of each week.

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 Health Information Part Two:
System (HIS) Technical Sections

> Illustrated Guide to EPI Report (FRONT)

A
Health Information System Organisation:

Reporting Form Location:

Reporting period:
7.0 EPI and Vitamin A

B 7.1a Children Vaccinated

Refugee National
Doses administered
<1 ≥ 1 to < 5 <1 ≥ 1 to < 5

BCG
Polio 0
Polio I
Polio II
Polio III
DPT I
DPT II
DPT III
Measles
Fully Vaccinated

C 7.2 Vaccine Supplied

No. of doses
Vaccine
supplied

BCG
Polio
DPT
Measles
Tetanus Toxoid

EPI REPORT_EN_090109

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 Module 7: Expanded Programme of Immunization (EPI)

A HEADER:

Organisation:
Print name of health partner
NOTES
Location:
Print name of Camp and Reporting Unit The dates of the reporting weeks are shown in the Reporting
Calendar. It is important that all staff are aware of these dates,
and that copies the calendar are distributed to all EPI clinics.
Reporting period:
The EPI supervisor is responsible for coordinating the complete
Enter number of week and month (e.g. Week 1
and timely submission of all sections contributing to the weekly
March) report.

B CHILDREN VACCINATED:
Complete Table 7.1, using the sum total of the
corresponding black number boxes in the daily EPI
tally sheets

C VACCINE WASTAGE:
Complete Table 7.2, by entering the number of doses
of each type of vaccine that were supplied to the
camp during the week.
NOTES
This information is not reported within the tally sheets and
requires separate records to be kept in each cold chain facility.
It is important for number of doses supplied to take into account
any doses of vaccine that were returned to the fridge (this does
NOT apply to BCG and Measles vaccine).

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 Health Information Part Two:
System (HIS) Technical Sections

> Illustrated Guide to EPI Report (REVERSE)

D 7.3 Vitamin A distribution

Doses distributed Refugee National

Post natal
Dose 1
Dose 2
Dose 3
Dose 4 + above

E 7.4 Tetanus Toxoid utilisation

Refugee National
Doses administered Non- Non-
Pregnant Other Pregnant Other
Preg. Preg.

TT 1
TT 2
TT 3
TT 4
TT 5

F
7.5 Growth Monitoring

Refugee
Number of children screened National
<1 ≥ 1 to < 5

Green (normal)
Yellow (borderline)
Red (danger)
Oedema

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 Module 7: Expanded Programme of Immunization (EPI)

Module 8

D VITAMIN A:
Complete Table 7.3, using the sum total of the
corresponding black number boxes in the daily
Vitamin A tally sheets

E TETANUS TOXOID:
Complete Table 7.4, using the sum total of the
corresponding black number boxes in the daily
Tetanus Toxoid tally sheets

F GROWTH MONITORING:
Complete Table 7.5, using the sum total of the
corresponding black number boxes in the daily
Growth Monitoring tally sheets

V-17